Stam A H, Haan J, van den Maagdenberg A M J M, Ferrari M D, Terwindt G M
Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.
Cephalalgia. 2009 Sep;29(9):1006-17. doi: 10.1111/j.1468-2982.2009.01940.x.
It is remarkable that migraine is a prominent part of the phenotype of several genetic vasculopathies, including cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL), retinal vasculopathy with cerebral leukodystrophy (RVCL) and hereditary infantile hemiparessis, retinal arteriolar tortuosity and leukoencephalopahty (HIHRATL). The mechanisms by which these genetic vasculopathies give rise to migraine are still unclear. Common genetic susceptibility, increased susceptibility to cortical spreading depression (CSD) and vascular endothelial dysfunction are among the possible explanations. The relation between migraine and acquired vasculopathies such as ischaemic stroke and coronary heart disease has long been established, further supporting a role of the (cerebral) blood vessels in migraine. This review focuses on genetic and acquired vasculopathies associated with migraine. We speculate how genetic and acquired vascular mechanisms might be involved in migraine.
值得注意的是，偏头痛是几种遗传性血管病变表型的一个突出部分，包括伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病（CADASIL）、伴有脑白质营养不良的视网膜血管病变（RVCL）以及遗传性婴儿偏瘫、视网膜小动脉迂曲和白质脑病（HIHRATL）。这些遗传性血管病变引发偏头痛的机制仍不清楚。常见的遗传易感性、对皮质扩散抑制（CSD）的易感性增加以及血管内皮功能障碍是可能的解释。偏头痛与诸如缺血性中风和冠心病等获得性血管病变之间的关系早已确立，这进一步支持了（脑）血管在偏头痛中的作用。本综述聚焦于与偏头痛相关的遗传性和获得性血管病变。我们推测遗传和获得性血管机制可能如何参与偏头痛。
